Visage Integrative Medicine, LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

VISAGE INTEGRATIVE MEDICINE, LLC

Practice address

3144 Executive Dr
San Angelo, TX 76904-6802

Phone

(325) 617-4594

Fax

(324) 617-4593

NPI assigned

Jan 19, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Susann Brundrett, MD

Title

Owner/Provider

Phone

(325) 234-2181

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• William Frank Bartosh, DDS

  • General Practice Dentistry
  • San Angelo, TX
  • NPI 1992809099
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1611014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611014400000",
    "number": "1497345003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3144 EXECUTIVE DR",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769046802",
            "telephone_number": "325-617-4594",
            "fax_number": "324-617-4593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3144 EXECUTIVE DR",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769046802",
            "telephone_number": "325-617-4594",
            "fax_number": "324-617-4593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISAGE INTEGRATIVE MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-19",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A",
        "authorized_official_last_name": "BRUNDRETT",
        "authorized_official_first_name": "SUSANN",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "325-234-2181",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yesenia Villanueva
• Alexis Diane Villarreal, HIS
• Autumn Villarreal
• Clarisa Ann Villarreal, M.S. CFY-SLP
• James Farley Villers, PT
• Kathie M Voigt-Field, DO
• Caleb Vosburg, MD
• Sherissa Voss Martinez, RBT
• Bryan Voss
• James Gregory Vretis II, D.O.

• Family Nurse Practitioner in San Angelo, TX
• Providers in San Angelo, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.